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Looking at this story it says that:

According to a study conducted by the Cancer Institute Hospital in Tokyo from 1995 to 2009, a total of 283 papillary thyroid cancer patients chose not to have surgery and opted instead to be monitored on a regular basis. None died nor saw the cancer spread, according to the study.

I see that this article, perhaps referencing the above survey, says something slightly different:

Since 2005, the Japanese group has treated all high-risk patients with total thyroidectomy (TT) plus radioactive iodine (RAI), while low-risk patients with unilateral PTC are given the option of either TT plus RAI or "less-than-total" thyroidectomy (LTT) — either lobectomy or subtotal thyroidectomy — along with routine central lymph-node dissection.

As far as I understand the technical terms, LTT in the second article implies removing the offending nodule, not the complete gland, which would suggest surgery, but on a smaller scale, whereas the first article implies people just get regular screening and no surgery.

So, what is the truth?

Ken Y-N
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1 Answers1

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The papillary thyroid cancer is a carcinoma, which by definition is a malignant tumor [1, 4]. This is supported by tumor properties [2]:

  • multifocality
  • unencapsulated (not always!)

But it is not an aggressive cancer. This lead to those results from the quoted story:

  • it is unlikely to invade blood vessels [3]
  • it does invade local lymph nodes, but with reduced malignant tissue [2]
  • differentiated cancer [4]
  • tends to grow "very slowly" [4]
  • is often treated successfully and rarely fatal [4]
  • high 5-year survival rate (96.7 % overall and 99.7 % for local carcinoma [3])
  • distant spread is not common [5]
  • low rate of clinical tumor recurrence [5]

References:

  1. Wikipedia contributors, "Carcinoma," Wikipedia, The Free Encyclopedia, http://en.wikipedia.org/w/index.php?title=Carcinoma&oldid=619458389 (accessed August 4, 2014).
  2. Wikipedia contributors, "Papillary thyroid cancer," Wikipedia, The Free Encyclopedia, http://en.wikipedia.org/w/index.php?title=Papillary_thyroid_cancer&oldid=615015671 (accessed August 4, 2014).
  3. Luigi Santacroce, MD. Papillary Thyroid Carcinoma. Available from http://emedicine.medscape.com/article/282276-overview (accessed 04.08.2014)
  4. American Cancer Society. Thyroid cancer. Available from http://www.cancer.org/acs/groups/cid/documents/webcontent/003144-pdf.pdf (accessed 04.08.2014)
  5. James Norman MD, FACS, FACE. Papillary Cancer: Symptoms, Treatments, and Prognosis for Papillary Thyroid Carcinoma. Available from http://www.endocrineweb.com/conditions/thyroid-cancer/papillary-cancer (accessed 04.08.2014)
Cornelius
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